2020-08-13T10:43:25-05:00 2019-09-30 BKD LLP 3102 WEST END AVENUE SUITE 1050 NASHVILLE TN 372031301 990 2018-10-01 610492356 EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER % WILLIAM SNAPP III EPHR 8592392424 217 SOUTH THIRD STREET DANVILLE KY 40422 WILLIAM SNAPP III CFO 8592392424 2020-08-15 true JESSICA FREEMAN P01261457 6159883600 167.68.126.162 62536020202265000012 2020-08-13 P D96EEA1EFD704BF3A6FD0CFD465A7C805E74B28F 960E2682245B9F8FA4870C9892C8D144138B2C2B 2018 2020-09-22 18:59:49Z DANIEL MCKAY 217 SOUTH THIRD STREET DANVILLE KY 40422 189438377 false X WWW.EMHEALTH.ORG X 1972 KY THE ORGANIZATION'S PRIMARY MISSION IS TO BE THE LEADING PROVIDER OF QUALITY HEALTH CARE SERVICES IN THE CENTRAL KENTUCKY COMMUNITIES WE SERVE. 18 16 1285 225 988100 25581 145906 189005 183516590 188130483 -200728 381015 774703 737874 184236471 189438377 0 1000 0 0 76397189 78796183 0 0 0 107185669 101106190 183582858 179903373 653613 9535004 243858157 256872318 11502949 14982119 232355208 241890199 X THE ORGANIZATION'S PRIMARY MISSION IS TO BE THE LEADING PROVIDER OF QUALITY HEALTH CARE SERVICES IN THE CENTRAL KENTUCKY COMMUNITIES WE SERVE. false false 151129263 1000 188130483 SEE SCHEDULE O. 151129263 true true false true false false false false false false true false false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true X 170 0 true 1285 true true true false false false false false false false false false false false X 18 16 false false false false true true true true true false false true true true true true true false false true true KY X WILLIAM SNAPP III 8592392424 217 SOUTH THIRD STREET DANVILLE KY 40422 SCOTT BOTTOMS CHAIR 6.0 14.0 X X 0 3300 0 JULIAN GANDER VICE CHAIR 6.0 14.0 X X 0 4500 0 JOHN D TRISLER TREASURER 6.0 14.0 X X 0 3300 0 ERIC GUERRANT MD SECRETARY 6.0 14.0 X X 0 6300 0 HUSSAM HAMDALLA MD BOARD MEMBER 2.0 38.0 X 0 966798 58622 JAMES TURPIN MD BOARD MEMBER 2.0 5.5 X 0 9300 0 ALLEN WHITE BOARD MEMBER 2.0 5.5 X 0 3300 0 REBECCA CHATHAM MD BOARD MEMBER 2.0 5.5 X 0 3300 0 BRIAN ELLIS MD BOARD MEMBER 2.0 38.0 X 0 295939 56835 SHEREE GILLIAM BOARD MEMBER 2.0 5.5 X 0 3000 0 CLIFF ED IRVIN BOARD MEMBER 2.0 5.5 X 0 3300 0 SUSIE ROUSH BOARD MEMBER 2.0 5.5 X 0 3300 0 AARON ROWLAND BOARD MEMBER 2.0 5.5 X 0 3300 0 MIKE W TAYLOR BOARD MEMBER 2.0 5.5 X 0 3900 0 JAMES W DUNN BOARD MEMBER 2.0 5.5 X 0 5100 0 THOMAS HAGER BOARD MEMBER 2.0 5.5 X 0 3300 0 DOUGLAS GREENBURG BOARD MEMBER 2.0 5.5 X 0 4950 0 CHRIS WHITWORTH BOARD MEMBER 2.0 5.5 X 0 1950 0 DANIEL MCKAY PRESIDENT & CEO 30.0 30.0 X 0 283332 25260 WILLIAM SNAPP III EXECUTIVE VP & COO 30.0 30.0 X 0 390340 61492 BURT PIPER EXECUTIVE VP & COO 30.0 30.0 X 0 348622 58955 LYNNE WARNER-LYNN VP OF CLINICAL EFFECTIVENESS 20.0 20.0 X 109065 109065 40146 JOAN HALTOM PHARMACY DIRECTOR 40.0 0.0 X 210926 0 37586 LIBBY MAYES EXECUTIVE DIRECTOR OF HR 40.0 0.0 X 187151 0 42693 RONALD BARBATO REHAB DIRECTOR 40.0 0.0 X 178614 0 38915 MICHELLE DELUCA FRALEY PHARMACIST 40.0 0.0 X 159444 0 47280 GARY NEAT EXECUTIVE DIRECTOR / CIO 40.0 0.0 X 157535 0 48817 SALLY DAVENPORT FORMER CEO 0.0 0.0 X 0 490876 36704 MARK MILNER FORMER VP & CNO 0.0 0.0 X 0 307510 40252 1002735 3257882 593557 88 true true false ABEL CONSTRUCTION CO INC 2401 STANLEY GAULT PARKWAY LOUISVILLE KY 40223 CONSTRUCTION 1074298 CENTRAL KENTUCKY SURGEONS PO BOX 129 DNAVILLE KY 40422 PHYSICIAN SERVICES 907365 IN COMPASS HEALTH INC 318 MAXWELL ROAD SUITE 500 ALPHARETTA GA 30009 PHYSICIAN SERVICES 2351115 KENTUCKY BLOOD CENTER 3121 BEAUMONT CENTER CIRCLE LEXINGTON KY 40513 BLOOD SERVICES 813159 LOGAN'S HEALTHCARE LINEN DIVISION PO BOX 643958 CINCINNATI OH 45264 LINEN SERVICE 475247 26 189005 189005 PATIENT REVENUE 621110 170463561 170463561 PHARMACY REVENUE 446110 2698087 2698087 JOINT VENTURE INCOME 621110 1929573 1929573 MEDSOURCE REVENUE 621110 12571864 11645611 926253 REFERENCE LAB 621500 61847 61847 405551 405551 188130483 56015 56015 0 0 6790 6790 0 6790 6790 325000 325000 325000 325000 0 0 0 0 0 0 0 0 0 VENDING COMMISSION 900099 20341 20341 CAFETERIA 722514 710426 710426 ALL OTHER MISC REVENUE 900099 317 317 731084 189438377 187142383 988100 1118889 X 0 1000 1000 0 0 132083 132083 0 63689024 53657594 10031430 2846779 2393429 453350 10765414 9051083 1714331 1362883 626437 736446 0 960 960 66447 66447 0 0 0 23442736 17127717 6315019 8776 8776 6472025 4762395 1709630 3039727 533641 2506086 0 2905436 1225769 1679667 77322 55751 21571 0 191002 169484 21518 1289235 1289235 0 7850895 7850895 960819 22723 938096 MEDICAL SUPPLIES 46280471 46280471 SHARED RESOURCE ALLOCATION 1513652 1513652 PROVIDER TAXES 2220973 2220973 REPAIRS & MAINTENANCE 3167676 2026541 1141135 1618038 310737 1307301 179903373 151129263 28774110 0 30776 60989 147219 160531 0 0 20153911 24664913 0 0 0 0 0 0 6885629 7159343 2263609 2041962 180889287 123649879 55690649 57239408 0 0 0 0 1343238 1277245 0 0 157343126 164267927 243858157 256872318 11502949 13146856 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1835263 11502949 14982119 X 232339918 241875409 15290 14790 0 0 232355208 241890199 243858157 256872318 9535004 -13 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 8403 8403 false SCH. C, PART III-B, LINE 1I LOBBYING EXPENDITURES --------------------- A PORTION OF DUES PAID TO THE KENTUCKY HOSPITAL ASSOCIATION (KHA) ARE USED FOR LOBBYING. 3116232 3116232 81569467 49701202 31868265 3577889 3366312 211577 87219916 67212000 20007916 5405783 3370365 2035418 57239408 SCHOLARSHIP ACCOUNT 15549 PHYSICIAN INCOME GUARANTEE 173520 DUE FROM RELATED PARTIES 164078858 164267927 0 DUE TO THIRD PARTY PAYERS 1835263 1835263 188924372 188924372 514005 514005 189438377 179389368 -514005 -514005 179903373 179903373 SCH D, PART XI & XII RECONCILIATION TO AUDIT REPORT ------------------------------ PART XI LINE 4B AMOUNTS INCLUDED IN 990 PART VIII BUT NOT ON LINE 1: --------------- CONTRIBUTION REV INCLUDED IN EXPENSE PER AUDIT 188,005 GAIN ON SALE OF ASSETS INCLUDED IN EXPENSE PER AUDIT 325,000 RECLASS OF CONTRIBUTION EXPENSE 1,000 --------- 514,005 PART XII LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON 990 PART IX: --------------- CONTRIBUTION REV INCLUDED IN EXPENSE PER AUDIT (188,005) GAIN ON SALE OF ASSETS INCLUDED IN EXPENSE PER AUDIT (325,000) RECLASS OF CONTRIBUTION EXPENSE ( 1,000) --------- (514,005) SCH D, PART X, LINE 2 INCOME TAXES ------------ The organization's audited financial statements did not include a footnote that addressed the organization's liability for uncertain tax positions under FIN48 (ASC 740). Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. true true X true X 125. true X true false true true 1852612 1852612 0.01030 32496947 26897341 5599606 0.03120 34349559 26897341 7452218 0.04150 34349559 26897341 7452218 0.04150 true 13290691 3915655 57443279 53619838 3823441 X true true CNTL KY SURGERY CTR ASC 0.6 0.4 1 1 EPHRAIM MCDOWELL REGIONAL MEDICAL CEN 217 SOUTH THIRD STREET DANVILLE KY 40422 WWW.EMHEALTH.ORG 100034 X X X EPHRAIM MCDOWELL REGIONAL MEDICAL CEN 1 false false true X X X X X X X X X 17 true false false true X SEE PART V SECTION C X true 17 true SEE PART V SECTION C false true X 125. 300. X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT --------------- THROUGH THE FOCUS GROUP AND ONLINE SURVEY, PARTICIPATION AND INPUT WAS GATHERED FROM REPRESENTATIVES OF PUBLIC HEALTH, AS WELL AS SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY(INCLUDING HISPANIC, AFRICAN AMERICAN), OR OTHER MEDICALLY UNDERSERVED POPULATIONS (SPECIFICALLY, THE ELDERLY, DISABLED, YOUNG ADULTS, LGBT COMMUNITY, THE MENTALLY ILL, INMATES, HEARING IMPAIRED, MEDICAID RECIPIENTS, AND THE UNINSURED). SCHEDULE H, PART V, SECTION B, LINE 7 & 10 CHNA / IMPLEMENTATION STRATEGY ---------------------------- THE CHNA REPORT AND THE IMPLEMENTATION STRATEGY CAN BE OBTAINED AT: HTTP://EMHEALTH.ORG/INDEX.PHP/SERVICES/COMMUNITY-SERVICES SCHEDULE H, PART V, SECTION B, LINE 11 ADDRESSING THE NEEDS OF THE COMMUNITY ------------------------------------- The internal stakeholders of Ephraim McDowell Regional Medical Center determined the following to be the top health priorities for the hospital to address in the community for the coming years: - Cardiovascular Disease (CVD) Related Risk Factors (e.g., hypertension, BMI, glucose, tobacco use, physical activity, nutrition) - Cancer Early Detection and Prevention - Childhood Obesity - Access to Health Services - Dementias, including Alzheimer's Disease - Mental Health & Mental Disorders These priority areas, and plans to address these, will be integrated into the hospital's Implementation Strategy. The rationale for selecting these areas is an understanding that impacting these would also impact many other areas of need identified in the assessment, such as diabetes, dementia, mental health, sensory impairment, kidney disease, respiratory disease, and disability. These areas also represent a continuation of existing work and allow the hospital to build on past successes. THERE ARE ADDITIONAL NEEDS IDENTIFIED WITHIN THE CHNA REPORT THAT ARE NOT SPECIFICALLY ADDRESSED BY EMRMC, DUE TO NO EXPERTISE OR LIMITED RESOURCES, BUT ARE BEING ADDRESSED BY OTHER AGENCIES WITHIN THE COMMUNITY. SCHEDULE H, PART V, SECTION B, LINE 16 PUBLICATION OF FAP -------------------- HTTP://EMHEALTH.PATIENTSIMPLE.COM/GUEST/#INDEX 9 CENTRAL KY SURGERY CENTER 230 WEST MAIN STREET DANVILLE KY 40422 OUTPATIENT SURGERY CENTER EPHRAIM MCDOWELL DIAGNOSTIC CENTER 101 DANIEL DRIVE DANVILLE KY 40422 DIAGNOSTIC IMAGING & TEST/LAB MEDSOURCE HOME MEDICAL 150 SOUTH THIRD STREET DANVILLE KY 40422 DUREABLE MEDICAL EQUIPMENT EPHRAIM MCDOWELL SLEEP DISORDERS 440 WHIRL-A-WAY DR DANVILLE KY 40422 SLEEP DISORDER CENTER EPHRAIM MCDOWELL SPINE PHYSICAL THERAPY 236 WEST MAIN ST DANVILLE KY 40422 OUTPATIENT REHAB FACILITY EPHRAIM MCDOWELL CANCER SUPPORT CENTER 520 TECHWOOD DR DANVILLE KY 40422 OUTPATIENT SERVICES EM DIABETES & ENDOCRINOLOGY CENTER 440 WHIRL-A-WAY DR DANVILLE KY 40422 DIABETES CENTER CASEY COUNTY REHABILITATION 513 MIDDLEBURG ST LIBERTY KY 42539 OUTPATIENT REHAB FACILITY EPHRAIM MCDOWELL EAR NOSE AND THROAT 120 DANIEL DRIVE DANVILLE KY 40422 OUTPATIENT SERVICES SCHEDULE H, PART III, LINE 2 BAD DEBT EXPENSE --------------- THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30, 2019. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. A DETAILED REVIEW OF PATIENT ACCOUNTS WAS PERFORMED AND THIS AMOUNT REFLECTS ACTUAL WRITE-OFFS OF BAD DEBT EXPENSE DURING THE PERIOD. SCHEDULE H, PART III, LINE 3 BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE ----------------------------------------- BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS REPORTED PER THE MEDICARE COST REPORT WORKSHEET S-10. THIS AMOUNT IS THE RESULT OF A DETAILED REVIEW OF PATIENT ACCOUNTS AND ACTUAL WRITE-OFFS OF BAD DEBT EXPENSE DURING THE PERIOD. SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE -------------- THE CORPORATION REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE CORPORATION PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE CORPORATION BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATEINT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. SCHEDULE H, PART III, LINE 8 MEDICARE SHORTFALL -------------------- AMOUNTS REPORTED ON LINES 5 AND 6 WERE BASED ON THE CORPORATION'S MEDICARE COST REPORT. SCHEDULE H, PART III, LINE 9B WRITTEN DEBT COLLECTION POLICY AND FINANCIAL ASSISTANCE ------------------------------------------------- IF IT IS DETERMINED THAT A PATIENT OR RESPONSIBLE PARTY IS ELIGIBLE FOR FINANCIAL ASSISTANCE, EMH WILL: - SEND WRITTEN NOTIFICATION TO THE RESPONSIBLE INDIVIDUAL OF THE ASSISTANCE DETERMINATION, AND - IF THE DISCOUNT IS LESS THAN 100%, EMH WILL: * PROVIDE THE RESPONSIBLE INDIVIDUAL WITH A BILLING STATEMENT SHOWING THE AMOUNT OWED, HOW THE AMOUNT WAS DETERMINED, AND DESCRIBE HOW THE INDIVIDUAL CAN LEARN MORE ABOUT HOW THE HOSPITAL CALCULATES AGB; * ISSUE REFUNDS TO THE RESPONSIBLE INDIVIDUAL IF HE OR SHE PREVIOUSLY PAID AN AMOUNT TO EMH EXCEEDING WHAT HE OR SHE IS PERSONALLY RESPONSIBLE TO PAY; AND * TAKE ALL REASONABLE MEASURES TO REVERSE ANY ECAS (WITH THE EXCEPTION OF A SALE OF A DEBT OR DEFERRING OR DENYING CARE FOR NON-PAYMENT OF AMOUNTS FOR PREVIOUS CARE) TAKEN AGAINST THE RESPONSIBLE INDIVIDUAL TO THE EXTENT POSSIBLE. IF A PATIENT CANNOT SATISFY STANDARD PAYMENT EXPECTATIONS, A FINANCIAL ASSISTANCE SCREENING PROCESS FOR ALTERNATIVE SOURCES OF BALANCE RESOLUTION IS COMPLETED. THOSE RESOLUTIONS MAY INCLUDE A DISCOUNT ON CHARGES, MEDICAID ENROLLMENT OR APPLICATION FOR CHARITY CARE. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT ------------------ IN 2017, PROFESSIONAL RESEARCH CONSULTANTS (PRC) WAS ENGAGED TO CONDUCT A NEEDS ASSESSMENT OF EMRMC'S COMMUNITY, WHICH IS DEFINED AS THE PRINCIPAL RESIDENTIAL ZIP CODES IN BOYLE, CASEY, GARRARD, LINCOLN, MERCER, AND WASHINGTON COUNTIES IN KENTUCKY. A SURVEY AND A COMMUNITY FOCUS GROUP WERE COMPLETED TO OBTAIN PRIMARY DATA FROM INDIVIDUALS WITHIN THE COMMUNITY. THE FOCUS GROUP WAS COMPRISED OF REPRESENTATIVES FROM PUBLIC HEALTH, SOCIAL SERVICE PROVIDERS, EMPLOYERS, AND OTHER COMMUNITY LEADERS. SELF REPORT DATA, MORTALITY, MORIDITY, LIFESTYLE, INCIDENCE OF CHRONIC DISEASE, INJURY DATA, AND DISABILITY DATA ARE PART OF THE ASSESSMENT PROCESS. THE BENCHMARK IS ESTABLIHSED USING HEALTHY PEOPLE 2020 DATA. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE -------------------------------------------- EMRMC'S CHARITY CARE POLICY IS POSTED ON THE WWW.EMHEALTH.ORG WEBSITE. AT REGISTRATION OF SELF-PAY CLIENTS, INFORMATION IS GIVEN ON REDUCED FEE, CHARITY APPLICATION, AND A REFERRAL TO A FINANCIAL COUNSELOR. THE FREE COMMUNITY SCREENINGS ARE POSTED ON THE WEBISTE AND IN AREA NEWSPAPERS IF THE HOSTING ORGANIZATION INVITES COMMUNITY PARTICIPATION. SOME EVENTS ARE DISCUSSED ON LOCAL RADIO. INFORMATION REGARDING THE FREE CLINIC IS ALSO GIVEN BY HEALTHCARE PROVIDERS, FAITH COMMUNITY NURSES, CASE WORKERS AND OTHER MEDICAL PROFESSIONALS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION -------------------------- THE HEALTH SYSTEM SERVES BOYLE, MERCER, CASEY, LINCOLN, GARRARD, AND WASHING COUNTIES, WHICH HAVE A RURAL POPULATION OF APPROXIMATELY 113,000. ACCESS IS AN ISSUE, DUE TO TRAVEL BARRIERS SUCH AS OUT-OF-DATE HIGHWAYS AND LACK OF PUBLIC TRANSPORTATION. THESE ACCESS ISSUES INFLUENCED THE DECISIONS TO SERVE WITH FREE SCREENINGS AT KEY GATHERING PLACES SUCH AS CHURCHES AND SCHOOLS, ETC. INSURANCE COVERAGE IS ANOTHER ISSUE. THE NUMBERS OF UNINSURED CONTINUES TO EXCEED THE NATIONAL AVERAGE AND THE UNDERINSURED IN THIS SERVICE AREA CONTINUES TO INCREASE POST ACA. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH ------------------------------------ OFFICERS AND STAFF OF EMRMC ARE ENGAGED IN LEADERSHIP POSITIONS WITH THE FOLLOWING: BOYLE COUNTY RELAY FOR LIFE; BOYLE COUNTY HEALTH DEPARTMENT; MERCER COUNTY HEALTH DEPARTMENT; CHAMBER OF COMMERCE AND ECONOMIC DEVELOPMENT AGENCIES IN BOYLE, LINCOLN, AND GARRARD COUNTIES; BOYLE COUNTY SCHOOL SYSTEM; 4-H COUNCIL; DANVILLE ROTARY CLUB; HEART OF DANVILLE; MCDOWELL HOUSE; CHRISTIAN CARE COMMUNITIES; FOUNDATION FOR HEALTHY KENTUCKY; KENTUCKY HOSPITAL ASSOCIATION AND DANVILLE KIWANIS. STAFF HAS ALSO GIVEN TESTIMONY AT LOCAL, STATE, AND FEDERAL LEVELS RELATED TO OUR SERVICE AREA'S HEALTH, EDUCATION, AND ECONOMIC ISSUES. EMRMC HAS AN OPEN MEDICAL STAFF COMPRISED OF PRIMARY CARE, SPECIALISTS AND SUBSPECIALISTS. PHYSICIAN RECRUITMENT IS BASED UPON COMMUNITY NEED WITH APPROVAL FROM THE GOVERNING BOARD. THE EMRMC AND EMH HEALTH SYSTEM BOARDS ARE COMPRISED OF COMMUNITY MEMBERS WITH REPRESENTATION FROM THE MEDICAL STAFF AND SENIOR LEADERSHIP, THE FORT LOGAN HOSPITAL BOARD, AND THE JAMES B. HAGGIN HOSPITAL BOARD. THE GOVERNING BOARD APPROVED THE ESTABLISHMENT AND FUNDING OF THE COMMUNITY SERVICE DEPARTMENT. WITH H1N1 OUTBREAK, THE COMMUNITY SERVICE DEPARTMENT APPROACHED CHURCHES IN THE SIX-COUNTY AREA WITH HAND-WASHING SIGNS, "COVER YOUR COUGH" POSTERS AND FLOOR-STAND HAND SANITIZERS TO HELP REDUCE THE RISK OF THE SPREAD OF FLU WITHIN CONGREGATIONS AND COMMUNITIES. PREVENTATIVE CARE, SUCH AS FLU SHOTS, ARE TAKEN TO THE COMMUNITY. SO, TOO, ARE ANNUAL SKIN CANCER CHECKS, MONTHLY BLOOD PRESSURE CHECKS, SEMI-ANNUAL GLUCOSE AND CHOLESTEROL CHECKS, ALONG WITH NURSE CONSULTS. SUCH SERVICES ARE OFFERED IN SCHOOLS, CHURCHES, AND OTHER PUBLIC ENTITIES IN THE REGION, INCLUDING THE STOCKYARDS IN LINCOLN COUNTY. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM ------------------------------- EMRMC IS A 222 LICENSED BED ACUTE CARE HOSPITAL SERVING THE COMMUNITY FOR NEARLY A CENTURY AS PART OF EPHRAIM MCDOWELL HEALTH (EMH). EMH IS A COMPREHENSIVE, INTEGRATED HEALTHCARE DELIVERY SYSTEM THAT SERVES 113,000 RESIDENTS FROM SIX COUNTIES IN SOUTH CENTRAL KENTUCKY. THE EMH BOARD IS COMPRISED OF COMMUNITY MEMBERS AND REPRESENTATION FROM FT LOGAN HOSPITAL, JAMES B. HAGGIN MEMORIAL HOSPITAL, MEDICAL STAFF, AND EMRMC LEADERSHIP. FT LOGAN HOSPITAL IS A CRITICAL ACCESS HOSPITAL LOCATED IN LINCOLN COUNTY. HEALTH RESOURCE IS COMPRISED OF CLINICS, AN EARLY CHILDHOOD DEVELOPMENT CENTER, ASSISTED LIVING FACULTY, AND DURABLE MEDICAL EQUIPMENT OUTLETS. THERE ARE REPRESENTATIVES FROM OUR SIX COUNTIES, MEDICAL STAFF, AND LEADERSHIP ON THE COMMUNITY BOARD THAT OVERSEES AND COORDINATES THE SERVICES OF EPHRAIM MCDOWELL HEALTH. ON DECEMBER 1, 2017, EMH ACQUIRED JAMES B. HAGGIN HOSPITAL, A CRITICAL ACCESS HOSPITAL LOCATED IN MERCER COUNTY. SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE ----------------------- TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY -------------------- THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEET 1. COST COMPUTED ON IRS WORKSHEET 3 WAS COMPUTED FROM THE MEDICARE COST REPORT, INCLUDING DIRECT COSTS PLUS OVERHEAD ALLOCATIONS COMPUTED IN THE COST REPORT STEP-DOWN PROCESS. true false false false false true true false false HUSSAM HAMDALLA MD BOARD MEMBER 0 777665 0 165910 0 23223 0 18200 0 40422 0 1025420 0 0 BRIAN ELLIS MD BOARD MEMBER 0 164077 0 74109 0 57753 0 22000 0 34835 0 352774 0 0 DANIEL MCKAY PRESIDENT & CEO 0 239534 0 30000 0 13798 0 9268 0 15992 0 308592 0 0 SALLY DAVENPORT FORMER CEO 0 380644 0 85212 0 25020 0 22000 0 14704 0 527580 0 0 WILLIAM SNAPP III EXECUTIVE VP & COO 0 311436 0 67319 0 11585 0 22000 0 39492 0 451832 0 0 BURT PIPER EXECUTIVE VP & COO 0 279736 0 58510 0 10376 0 22000 0 36955 0 407577 0 0 MARK MILNER FORMER VP & CNO 0 110771 0 29346 0 167393 0 12199 0 28053 0 347762 0 0 LYNNE WARNER-LYNN VP OF CLINICAL EFFECTIVENESS 88521 88521 10639 10639 9905 9905 8920 8920 11153 11153 129138 129138 0 0 JOAN HALTOM PHARMACY DIRECTOR 194734 0 12983 0 3209 0 13036 0 24550 0 248512 0 0 0 LIBBY MAYES EXECUTIVE DIRECTOR OF HR 156721 0 14849 0 15581 0 15207 0 27486 0 229844 0 0 0 RONALD BARBATO REHAB DIRECTOR 159929 0 10234 0 8451 0 14591 0 24324 0 217529 0 0 0 MICHELLE DELUCA FRALEY PHARMACIST 154920 0 0 0 4524 0 13424 0 33856 0 206724 0 0 0 GARY NEAT EXECUTIVE DIRECTOR / CIO 133967 0 14973 0 8595 0 13056 0 35761 0 206352 0 0 0 SCHEDULE J, PART I, QUESTION 3 ESTABLISHING CEO COMPENSATION ------------------------- THE CEO IS COMPENSATED BY EPHRAIM MCDOWELL HEATH, INC. (EMH), A RELATED ORGANIZATION. EMH USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS -------------------- MARK MILNER LEFT EPHRAIM MCDOWELL IN MAY 2018. HIS SEVERANCE OF $156,515 WAS REPORTED IN HIS W-2. SCHEDULE J, PART I, LINE 6A & 6B MANAGEMENT INCENTIVE PLANS ------------------------------- EMRMC IS AN AFFILIATE OF EPHRAIM MCDOWELL HEALTH, INC. WHICH HAS MANAGEMENT INCENTIVE PLANS FOR CORPORATE OFFICERS, SENIOR VICE-PRESIDENTS, VICE-PRESIDENTS, AND DIRECTORS. ANNUAL PAYOUTS RELATED TO THESE INCENTIVE PLANS HAVE TWO COMPONENTS. 30% OF THE ANNUAL PAYOUT IS BASED ON NET OPERATING INCOME GOALS COMPARED TO BUDGET. THE OTHER 70% IS BASED ON QUALITY MEASURES, PATIENT SATISFACTION GOALS, ASSOCIATE SATISFACTION GOALS, AND SAFETY MEASURES. FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS ------------------------------ EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER (EMRMC) IS A NOT-FOR-PROFIT, 222-BED LICENSED LEVEL III TRAUMA CENTER DEDICATED TO SERVING THE HEALTH AND WELLNESS NEEDS OF THE POPULATIONS OF BOYLE, LINCOLN, MERCER, GARRARD, CASEY AND WASHINGTON COUNTIES. THE FACILITY IS JOINT COMMISSION ACCREDITED. EMRMC'S SCOPE OF SERVICES INCLUDE: BEHAVIORAL HEALTH, CANCER CARE CENTER, OUTPATIENT CANCER CARE, CARDIAC CARE SERVICES, CRITICAL CARE, DIABETES AND ENDOCRINOLOGY, DIAGNOSTIC SERVICES, LEVEL III TRAUMA/EMERGENCY CARE CENTER, KIDS CAN DO PEDIATRIC THERAPY CENTER, LABORATORY SERVICES, MEDICAL-SURGICAL SERVICES, ORTHOPEDIC/SPINE CARE, PASTORAL CARE, PAIN MANAGEMENT CENTER, PULMONOLOGY, REHABILITATION, RESPIRATORY THERAPY, SURGICAL SERVICES, VASCULAR SERVICES, VOLUNTEER/AUXILIARY, WOMEN'S HEALTH SERVICES, WOMEN'S BREAST & HEALTH CENTER, WOUND HEALING CENTER, SLEEP DISORDERS CENTER, EAR, NOSE, AND THROAT SERVICES, UROLOGY, HOME HEALTH, NEUROLOGY, PODIATRY, GASTROENTEROLOGY AND DURABLE MEDICAL EQUIPMENT. EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER FOR FISCAL YEAR (FY) 2019 EXPERIENCED 6,887 ADMISSIONS INCLUDING NURSERY, AND 32,555 PATIENT DAYS FOR ALL SERVICES INCLUDING NURSERY AND OBSERVATION DAYS. OUTPATIENT REGISTRATIONS (INCLUDING ER VISITS) WERE 140,283 COMPARED TO 135,903 IN FY 2018. SURGICAL PROCEDURES AT EMRMC WERE 5,075 IN FY 2019 AS COMPARED TO 4,718 IN FY 2018, REFLECTING AN INCREASE IN PROCEDURES. THE AMBULATORY SURGICAL CENTER PROCEDURES IN FY 2019 WERE 5,348 VERSES 5,340 IN FY 2018. EXPANDED SERVICE MODALITIES HAVE BEEN CONTINUED TO INCREASE ACCESS TO CARE NEEDED FOR THE ELDERLY, FRAIL, OR THOSE WITH CANCER (ALL HIGH-VOLUME POPULATIONS WITHIN THE SIX COUNTIES) TO RECEIVE CARE CLOSE TO HOME. KEY SERVICE MODALITIES INCLUDED THE FOLLOWING: RADIOFREQUENCY- WE CONTINUE TO PROVIDE TARGETED VERTEBRAL AUGMENTATION FOR THE TREATMENT OF SPINE FRACTURES (ALSO KNOWN AS VERTEBRAL COMPRESSION FRACTURES) AS COMMONLY SEEN IN OSTEOPOROSIS. KENTUCKY HAS ONE OF THE HIGHEST RATES OF CITIZENS OVER THE AGE OF 65, AND AGE IS A RISK FACTOR FOR SPINAL FRACTURES. CANCER IS THE NUMBER TWO CAUSE OF DEATH IN THE SERVICE AREA; THEREFORE, WE CONTINUE TO PROVIDE TARGETED-RADIOFREQUENCY ABLATION (T-RFA) THERAPY FOR RAPID PAIN RELIEF FROM METASTATIC SPINAL TUMORS AS A TREATMENT OPTION FOR CANCER CARE. COMMUNITY HEALTH EDUCATION - GENERAL ---------------------------------------- CANCER EDUCATION - VARIOUS SPORTS GROUPS AND COMMUNITY ORGANIZATIONS RECEIVED SUN SAFETY PRODUCTS AND EDUCATION. EPA SUN SAFETY LITERATURE, SUN SCREEN AND LIP BALM WITH SUN SCREEN WERE DISTRIBUTED TO RE-ENFORCE THE MESSAGE OF SUN SAFETY. ALL FUNDED BY THE EPHRAIM MCDOWELL HEALTH CARE FOUNDATION (EMHCF). CPR/FIRST AID - DUE TO LACK OF TIME AND AVAILABILITY, NO CPR TRAINING WAS CONDUCTED IN FY2019. EDUCATION WEBSITE/COMMUNITY PUBLICATION - TWELVE EDITIONS OF THE HEALTH MINISTRY/FAITH COMMUNITY NURSING NEWSLETTER WERE PRODUCED, AND DISTRIBUTED IN KENTUCKY, TENNESSEE, INDIANA, OHIO, VIRGINIA, AND NORTH CAROLINA. THE INTENT IS TO PROVIDE RELEVANT AND CURRENT INFORMATION TO THE CONGREGATIONS RELATED TO SELF-CARE, OR EDUCATION ON DISEASE PROCESSES, TREATMENTS AND PREVENTION, INCLUDING BUT NOT LIMITED TO INTENTIONAL CARE OF THE SPIRIT. ALL INFORMATION CAN BE REPRODUCED AND USED FOR CONGREGATIONAL INFORMATION/EDUCATION. HEALTH FAIRS - SERVICES WERE OFFERED AT 25 EVENTS AT 17 SITES IN BOYLE, LINCOLN, GARRARD, MERCER, AND WASHINGTON COUNTIES WITH FOCUS ON REACHING AT RISK AND VULNERABLE POPULATIONS. INCLUDING ALL ADULT PROGRAMS, 10,615 COMMUNITY CONTACTS OCCURRED (SCREENINGS, EDUCATION, SUPPORT GROUPS, NEWS ARTICLES, RADIO SPOTS, ETC.). THIRTY-SIX PERCENT OF SCREENED PARTICIPANTS WERE MALE; 64 PERCENT WERE FEMALE. NINETY PERCENT OF 412 CLIENTS SERVED DECLARING ETHNICITY WERE CAUCASIAN, SIX PERCENT WERE AFRICAN AMERICAN, AND ONE PERCENT WERE HISPANIC. FIFTY-SIX PERCENT OF PARTICIPANTS SERVED BY COMMUNITY BENEFIT PROGRAMS HAD A HOUSEHOLD INCOME BELOW $35,000 (THIS IS A 6 PERCENT INCREASE). EIGHTEEN PERCENT OF PARTICIPANTS SERVED WERE UNEMPLOYED; A NINE PERCENT INCREASE IN UNEMPLOYMENT FROM FY 2018 AND AN EIGHT PERCENT INCREASE OVER FY 2017. FIFTY PERCENT OF THE POPULATION SERVED WERE RETIRED, COMPARED TO 41% RETIRED IN FY 2018 AND 43% RETIRED IN FY 2017. THE UNINSURED SERVED WERE 7 PERCENT COMPARED TO 8% IN FY 2018 AND 7% IN FY 2017. EIGHTY SIX PERCENT OF PARTICIPANTS REPORTED HAVING A PRIMARY CARE PROVIDER (PCP) COMPARED TO 76% IN 2018, 82% IN FY 2017 AND 78% IN FY 2016. A REGISTERED NURSE (RN) MET WITH EACH CLIENT TO DEVELOP A WRITTEN PLAN TO DECREASE LIFESTYLE ASSOCIATED HEALTH RISK BEHAVIORS. AT EACH SCREENING, REFERRAL OPTIONS WERE PROVIDED, INCLUDING HOPE CLINIC, REDUCED FEE PROGRAM AND PRIMARY CARE PROVIDER (PCP) LISTINGS FOR THE REGION FOR THE UNINSURED PARTICIPANTS OR THOSE WITHOUT A PCP. FIFTY-TWO PERCENT OF SCREENING TESTS WERE ABNORMAL (A 2% INCREASE OVER 2018 AND A 1% INCREASE OVER 2017) WITH 24 PERCENT REQUIRING A REFERRAL FOR FOLLOW-UP (A 7% INCREASE OVER 2018 AND A 6% INCREASE OVER 2017). PARISH NURSING PROGRAM - GRANT FUNDING FROM EPHRAIM MCDOWELL HEALTH CARE FOUNDATION MADE POSSIBLE THE FAITH COMMUNITY NURSING EDUCATIONAL PROGRAMS. THE LAST FAITH COMMUNITY NURSING SYMPOSIUM WAS PRESENTED IN THE FALL OF 2016; WE ANTICIPATED CONDUCTING A SYMPOSIUM EVERY OTHER YEAR ALTERNATING WITH THE FAITH COMMUNITY FOUNDATIONS COURSE. DUE TO CHANGES IN EMPLOYMENT, A SECOND SYMPOSIUM WAS NOT DONE IN 2019. THE FAITH COMMUNITY NURSING FOUNDATION COURSE WAS HELD IN THE SPRING OF 2018 PRODUCING 5 NEW FAITH COMMUNITY NURSES. NEITHER A SYMPOSIUM NOR A FAITH COMMUNITY FOUNDATIONS COURSE WERE OFFERED IN 2019 DUE TO STAFF REDUCTIONS BUT A FOUNDATIONS COURSE IS PLANNED FOR 2020. ONE HUNDRED AND EIGHT PARTICIPANTS HAVE COMPLETED THE FAITH COMMUNITY NURSING FOUNDATION COURSE SINCE ITS INCEPTION AT EMRMC IN 2008 AND SERVE AS VOLUNTEERS WITHIN THEIR CONGREGATIONS. THESE COMMUNITY PARTNERS SERVE IN 23 COUNTIES WITHIN THE COMMONWEALTH OF KENTUCKY, TENNESSEE, VIRGINIA, NORTH CAROLINA AND OHIO AND SUPPORT PERSONS OF ALL DENOMINATIONS. TWELVE HEALTH MINISTRY NEWSLETTERS WERE CREATED AND DISSEMINATED TO HEALTH MINISTRY PARTNERS IN KENTUCKY, OHIO, ILLINOIS, INDIANA, TENNESSEE, VIRGINIA AND NORTH CAROLINA. WITHIN THE IMMEDIATE SERVICE AREA THE FOLLOWING VOLUNTEER FAITH COMMUNITY NURSING SERVICES WERE ACTIVE: FIRST BAPTIST JUNCTION CITY, FIRST BAPTIST ON THE BY PASS, LEXINGTON AVENUE BAPTIST CHURCH, PERRYVILLE BAPTIST CHURCH, NEW SALEM BAPTIST CHURCH, INDIAN HILLS CHRISTIAN CHURCH, CENTENARY UNITED METHODIST CHURCH - DANVILLE, HARRODSBURG CHRISTIAN CHURCH, SAINTS PETER & PAUL CATHOLIC CHURCH, ST. ANDREW'S CATHOLIC CHURCH, LEVEL GREEN CHRISTIAN, DANVILLE NEW COVENANT OF NAZARENE CHURCH, TRINITY CHURCH, AND GETHSEMANE BAPTIST CHURCH. ACTIVITIES INCLUDE, BUT ARE NOT LIMITED TO, HOME VISITS, NURSING HOME VISITS, BLOOD PRESSURE CHECKS, HEALTH AND WELLNESS PROGRAMS, SUPPORT GROUPS, REFERRALS FOR FOLLOW-UP CARE, ORGANIZING FLU CLINICS, ORGANIZING HEALTH SCREENINGS, ACUTE CARE VISITS, ARRANGING FOR MEAL DELIVERIES, AND EMERGENCY ASSISTANCE (SEIZURES, CHEST PAIN, FAINTING, HYPERTENSIVE CRISIS, ETC.). STATISTICAL ANALYSIS SHOWS THE MORE VISITS THE CONGREGANT HAS WITH THE FAITH COMMUNITY NURSE REGARDING THEIR BLOOD PRESSURE THE BETTER THEIR BLOOD PRESSURE IS CONTROLLED. SCHOOL-BASED PROGRAMS - THE SCHOOL BASED PROGRAMS WERE NO LONGER SPEARHEADED BY EPHRAIM COMMUNITY SERVICE STAFF DUE TO THE LACK OF PERSONNEL. HOWEVER, AREA SCHOOLS CONTINUED THE PERKINS ASSESSMENTS AND TRACKING OF BMI WHICH WE VIEW AS A MARK OF SUCCESS IN OUR EFFORTS TO EDUCATE THE COMMUNITY. SPEAKERS BUREAU (HEALTH TOPICS) - MAGNETS WITH SIGNS AND SYMPTOMS OF A STROKE WERE GIVEN AWAY AT SPEAKING EVENTS AND SCREENING EVENTS. MAGNETS WITH SIGNS AND SYMPTOMS OF A HEART ATTACK WERE ALSO DISTRIBUTED AT HEALTH SCREENINGS AND SPEAKING ENGAGEMENTS. EARLY HEART ATTACK CARE BROCHURES AND EARLY WARNING SIGNS BOOK MARKS WERE DISTRIBUTED AT SCREENINGS AS WELL. STROKE PREVENTION AND RECOGNITION EDUCATION WAS PROVIDED IN THE COMMUNITY AS PART OF THE UK STROKE AFFILIATE NETWORK EFFORT TO REDUCE MORTALITY AND MORBIDITY RELATED TO CVD IN SOUTH CENTRAL KENTUCKY. EDUCATION REGARDING RISK FACTOR REDUCTION AND HEALTHY LIFESTYLE CHOICES FOR BOTH HEART ATTACK AND STROKE IS A REGULAR COMPONENT OF EACH HEART ATTACK RISK OR STROKE RISK SCREENING. THE COMMUNITY EDUCATION WAS ALL A COMPONENT OF THE CHNA IMPLEMENTATION PLAN. COMMUNITY HEALTH EDUCATION - SELF HELP ----------------------------------------- FITNESS / EXERCISE - FIFTY ATTENDEES PARTICIPATED IN THE "GET MOVING" SPRING CHALLENGE, A SCAVENGER HUNT GROUP WALK AT THE SPEARS CREEK CONNECTOR (LOW TURNOUT WAS DUE TO INCLEMENT WEATHER). OVER EIGHT HUNDRED PARTICIPANTS TOOK PART IN THE SPRING "GET MOVING" CHALLENGE, WITH SEVEN HUNDRED AND FIFTY COMPLETING THE PROGRAM. FORM 990, PART III, LINE 4A (CONT) TOBACCO / SMOKING CESSATION - WE SAW AN INCREASE IN THE NUMBER OF INDIVIDUALS REPORTING TOBACCO USE; 62 COMPARED TO 39 IN 2018 COMPARED TO 69 IN 2017 AND 106 IN FY 2016. THE INCREASE MAY DUE TO THE INCREASED VOLUME OF CLIENTS IN THE DRUG REHABILITATION FACILITIES. THERE SEEMS TO BE AN INCREASING DECLINE IN TOBACCO USE AMONG THE GENERAL POPULATION SCREENED. THE DECREASE MAY BE A CONTINUED EFFORT AT EDUCATION LOCALLY AND STATEWIDE, ALONG WITH THE STATE LEGISLATION TO INCREASE THE TAX ON CIGARETTES AS WELL AS FEDERAL EFFORTS. THERE IS AN INCREASE IN E-CIGARETTE SHOPS IN THE BOYLE COUNTY AND SURROUNDING AREAS. EARLY RESEARCH INDICATES THAT USE OF E-CIGARETTES OR VAPOR DEVICES DO NOT DECREASE TOBACCO USE BUT ACTUALLY RESULTS IN INCREASED TOBACCO USE DUE TO THE NICOTINE USED IN THE DEVICES. A STATE-WIDE TOBACCO FREE SCHOOLS BILL (WHICH INCLUDES CIGARETTES, OTHER FORMS OF TOBACCO, AND VAPOR DEVICES) WAS PASSED UNANIMOUSLY BY THE KENTUCKY LEGISLATURE AND NOW THE FEDERAL LAW PROHIBITS SALES TO MINORS YOUNGER THAN 21 YEARS OF AGE. PLANS HAVE BEEN MADE BY THE HEALTH DEPARTMENTS AND SOAHEC FOR E-CIGARETTE AND VAPOR PRODUCTS TO BE PART OF BOTH THE LEGISLATIVE PROPOSAL AND PUBLIC EDUCATION DUE TO THE OBSERVATION OF INCREASED USE OF THESE PRODUCTS, ESPECIALLY BY THE YOUTH. SPECIAL EMPHASIS ON E-CIGARETTE USE WAS PART OF THE EPHRAIM MCDOWELL FAITH COMMUNITY NURSING SYMPOSIUM OF 2017 AND E-CIGARETTE USE IS PART OF THE SMOKING ASSESSMENT AND EDUCATION OF EACH COMMUNITY HEALTH SCREENING. STRESS MANAGEMENT - ONLY 15 INDIVIDUALS WERE SCREENED USING THE PERCEIVED STRESS SCALE COMPARED TO 42 IN 2018 AND 82 INDIVIDUALS IN 2017 AND 212 INDIVIDUALS IN 2016 BECAUSE SMALLER SITES WERE USED TO DO THE HEART RISK SCREENINGS. OF THE 15 SCREENED, NO ONE HAD AN ABNORMAL SCREENING IN 2019 WHILE TWO PERCENT OF THOSE SCREENED WERE ABNORMAL IN 2018 COMPARED TO SIXTEEN PERCENT IN 2017 AND APPROPRIATE REFERRALS TO EITHER PRIMARY CARE PROVIDERS OR MENTAL HEALTH CARE PROVIDERS WERE MADE. IN 2019, NO ONE SCREENED FOR DEPRESSION USING THE BECK DEPRESSION SCALE WAS ABNORMAL COMPARED TO TWO OUT OF 40 SCREENED FOR DEPRESSION IN 2018. THIS WAS MOST LIKELY DUE TO THE EXTREMELY SMALL POPULATION SCREENED THAT IT WAS A CHURCH POPULATION. RESEARCH TENDS TO SUPPORT THAT FACT THAT CHURCH MEMBERS HAVE A LOWER LEVEL OF REPORTED STRESS AND DEPRESSION DUE TO PRAYER, MEDITATION AND GROUP SUPPORT. THE DECISION TO INCREASE THE USE OF THE PERCEIVED STRESS SCALE RELATES TO THE INCREASED EMPHASIS OF THE ROLE OF STRESS IN MORTALITY AND MORBIDITY OF CARDIOVASCULAR PATIENTS, ESPECIALLY WOMEN. ALL RECEIVED INFORMATION RELATED TO STRESS REDUCTION STRATEGIES. THIS IS CONSISTENT WITH THE 2015-2017 STRATEGIC OBJECTIVE RELATED TO MENTAL HEALTH IN THE EMRMC IMPLEMENTATION PLAN BUT NOT INCLUDED THE PLAN FOR 2018. A DECISION TO CONTINUE THESE SCREENINGS WAS MADE DUE TO THE DOCUMENTED CORRELATION BETWEEN DEPRESSION AND HEART ATTACKS. COMMUNITY HEALTH EDUCATION - SUPPORT GROUPS ------------------------------------ ALZHEIMER'S - TEN ALZHEIMER'S SUPPORT GROUP MEETINGS WERE FACILITATED BY AN ADVANCED PRACTICE MENTAL HEALTH NURSE PRACTITIONER. THE GROUP SERVES BOTH PATIENTS AND CARE-GIVERS/FAMILY. GIVEN THE INCIDENCE RATE OF STROKE AND THE AGING OF THE POPULATION IT IS ANTICIPATED THE NEED FOR THIS SERVICE WILL CONTINUE TO GROW IN THIS REGION. COMMUNITY-BASED CLINICAL SERVICES - HEALTH SCREENINGS ------------------------------------------------------ BLOOD PRESSURE SCREENING - BLOOD PRESSURE SCREENINGS WERE OFFERED AT 17 SITES (25 EVENTS), SOME MORE THAN ONCE, AND THIS DOES NOT INCLUDE BLOOD PRESSURE SCREENINGS DONE BY FAITH COMMUNITY NURSES IN THEIR OWN CONGREGATIONS; FOUR HUNDRED AND SEVENTY - SIX INDIVIDUALS WERE SERVED WITH 468 PERSONS HAVING THEIR BLOOD PRESSURE CHECKED. THIS REPRESENTS AN INCREASE IN BLOOD PRESSURE SCREENINGS FROM THE PRIOR YEAR WHEN 447 INDIVIDUALS WERE SERVED AND A DECREASE FROM 2017 WERE 599 INDIVIDUALS WERE SERVED; THIS FLUCTUATION IS DUE TO THE DECREASE IN SITES AND SCREENINGS AS A RESULT OF STAFF REDUCTIONS AND BUDGET CONSTRAINTS IN FY 2018. BLOOD PRESSURE READINGS THAT EXCEEDED THE RECOMMENDED RANGE BY THE AMERICAN HEART ASSOCIATION (AHA) REMAINED CONSISTENT WITH FY 2018: 86% IN FY 2018 COMPARED TO 83 PERCENT IN FY 2017, AND 90 PERCENT IN FY 2016. THOSE CLASSIFIED AS PRE-HYPERTENSIVE RECEIVED INSTRUCTIONS FOR MONITORING AND RECORDING AS WELL AS DIETARY INSTRUCTIONS RELATED TO LOW SODIUM DIET. THOSE THAT WERE ON MEDICATIONS BUT EXCEED THE RECOMMEND RANGE WERE INSTRUCTED TO SHARE THE FINDING WITH THEIR PRIMARY CARE PROVIDER (PCP). THOSE AT STROKE LEVEL WERE TRANSPORTED FOR IMMEDIATE FOLLOW-UP BY A PHYSICIAN. BLOOD PRESSURE CONTROL IS A MAJOR FACTOR IN CARDIOVASCULAR DISEASE RISK REDUCTION. THE INTENSE FOCUS ON BLOOD PRESSURE MONITORING, SELF-CARE EDUCATION AND FOLLOW-UP CONTINUES. BLOOD PRESSURE SCREENING IS ONE OF THE IMPLEMENTATION STRATEGIES RELATED TO MODIFIABLE LIFESTYLE RELATED CARDIOVASCULAR RISK FACTORS FROM THE 2017 CHNA IMPLEMENTATION PLAN. CANCER - COLECTORAL SCREENING - DURING MARCH THE EPHRAIM MCDOWELL HEALTH CARE FOUNDATION (EMHCF) FUNDED COLORECTAL SCREENINGS AT 25 SITES IN ADDITION TO NORMAL SCREENING SITES FOR A TOTAL DISTRIBUTION OF 94 KITS. TOTAL COLORECTAL SCREENING KITS DISTRIBUTED DURING FY 2019 WERE 198 WITH A 47 PERCENT RETURN RATE; A 13% DECREASE FROM 2018 (88 OF 146), 7% DECREASE (115 OF 214) IN RETURN FROM 2017. TWO OF 198 (1%) HAD POSITIVE RESULTS AND WERE REFERRED TO THEIR PCP. KITS WERE DISTRIBUTED IN SIX COUNTIES. SITES INCLUDED CHURCHES, SENIOR CITIZEN CENTERS, THE WELLNESS CENTER, HEALTH DEPARTMENTS, CLINICS, HOSPITAL LOBBIES, AREA BUSINESSES, THE CANCER CENTER, HOSPICE, LOCAL BANK, AND THE COUNTY EXTENSION SERVICE OFFICES. THERE HAVE BEEN RADIO AND NEWSPAPER PUBLIC SERVICE AWARENESS CAMPAIGNS RELATED TO COLORECTAL CANCER DUE TO KENTUCKY RATING NUMBER ONE IN INCIDENCE AND NUMBER 3 IN DEATHS RELATED TO COLON CANCER. THIS IS ONE OF THE IMPLEMENTATION STRATEGIES FOR EARLY DETECTION OF CANCER BASED UPON THE IDENTIFIED NEED IN THE 2017 CHNA. CANCER - SKIN SCREENING - SKIN SCREENING BY A LICENSED INDEPENDENT PRACTITIONER (LIP) WAS NOT DONE IN FY 2019 BECAUSE THERE WAS NO LIP AVAILABLE TO DO THE SCREENING THROUGH COMMUNITY SERVICE... SUN SAFETY EDUCATION BEGINS WITH THE SCHOOL-AGE CHILDREN AND CONTINUES ACROSS THE LIFE SPAN AND HAS BEEN A CONSISTENT MESSAGE AND FOCUS OF THE COMMUNITY SERVICE WORK PLAN SINCE INCEPTION IN 2008. THIS IS ONE OF THE IMPLEMENTATION STRATEGIES FOR EARLY DETECTION/PREVENTION OF CANCER BASED UPON THE IDENTIFIED NEED IN THE 2017 CHNA. CHOLESTEROL TESTING - TOTAL CHOLESTEROL WAS MEASURED FOR 445 CLIENTS IN FIVE COUNTIES AT 17 SITES WITHIN HEALTH MINISTRIES AND COMMUNITY SETTINGS WITH 44 PERCENT OF PARTICIPANTS EXCEEDING THE RECOMMEND RANGE AS SET BY THE AMERICAN HEART ASSOCIATION (AHA); THIS IS A 4 PERCENT INCREASE COMPARED TO 40% IN 2018 AND 8% INCREASE (36 %) IN 2017. THIS TREND IS CONSISTENT WITH THE INCREASE SEEN NATIONALLY. WITHIN THE LIPID PANEL 47% OF PARTICIPANTS HAD ONE OR MORE MEASURE(S) OUTSIDE THE RECOMMENDED RANGE COMPARED TO 43% IN FY 2018 AND 42.7 PERCENT IN FY 2017. LOW DENSITY LIPIDS BEING ELEVATED WAS THE LEADING CAUSE. EFFECTIVE FY 2013, WITH SUPPORT FROM AREA PEDIATRICIANS, THE DEPARTMENT BEGAN OFFERING LIPID SCREENINGS FOR CHILDREN AGE 12 AND ABOVE, IF ACCOMPANIED BY A PARENT. WE HAVE NOT SEEN A STATISTICALLY SIGNIFICANT NUMBER OF PARTICIPANTS IN THE PEDIATRIC AGE RANGE. LIPID PANEL SCREENING IS ONE OF THE IMPLEMENTATION STRATEGIES RELATED TO MODIFIABLE LIFESTYLE RELATED CARDIOVASCULAR RISK FACTORS FROM THE IMPLEMENTATION PLAN BASED ON THE 2017 CHNA. THIS IS PART OF BOTH THE STROKE RISK AND MYOCARDIAL RISK REEDUCATION STRATEGY. DIABETES SCREENING - BLOOD GLUCOSE TESTING WAS CONDUCTED ON 449 PARTICIPANTS. THIRTY PERCENT EXCEEDED THE RECOMMENDED RANGE AS SET BY THE AMERICAN DIABETES ASSOCIATION (ADA) COMPARED TO 37% IN FY 2018 AND 20% IN FY 2017. THIS IS CONSISTENT WITH THE INCREASE IN TYPE II DIABETES NATIONWIDE WITH KY BEING ONE OF THE LEADING STATES IN INCIDENCE OF DIABETES. NO ONE WAS BELOW THE RECOMMENDED RANGE. BASED UPON THE NATIONAL INCIDENCE TREND AND THE LOCAL TREND IN DIABETES, A1C MONITORING EQUIPMENT WAS PURCHASED WITH A GRANT THAT WAS SUBMITTED IN FY 2015 AND APPROVED. INDIVIDUALS AT RISK FOR DIABETES OR DIAGNOSED WITH DIABETES ARE NOW SCREENED WITH THE A1C MACHINE AS OF FY 2016. ONLY 75 INDIVIDUALS WERE SCREENED WITH THE A1C EQUIPMENT DUE TO PRIOR SCREENING OF INDIVIDUALS BY THEIR PRIMARY CARE PROVIDER. SIXTY-THREE PERCENT OF THOSE SCREENED WERE ABOVE NORMAL COMPARED TO 41% OF 88 INDIVIDUALS IN 2018 AND 48% OF ONE HUNDRED AND SIXTY INDIVIDUALS SCREENED IN FY 2017. LIFESTYLE CHANGE AND DIET EDUCATION WAS PROVIDED AS WELL AS REFERRALS TO PRIMARY CARE PHYSICIANS. GLUCOSE TESTING WAS OFFERED TO CHILDREN AGE 12-18, IF ACCOMPANIED BY A CUSTODIAL PARENT. AGAIN, THE NUMBER OF PEDIATRIC PARTICIPANTS WAS NOT STATISTICALLY SIGNIFICANT. THIS STRATEGY IS PART OF THE CVD RISK REDUCTION IMPLEMENTATION PLAN THAT WAS FORM 990, PART III, LINE 4A (CONT) NUTRITION/OBESITY SCREENING - HEIGHT, WEIGHT, PERCENT BODY FAT, AND CALCULATED BODY MASS INDEX (BMI) WAS OFFERED AT 17 SITES IN FIVE COUNTIES WITH 416 ADULT PARTICIPANTS. SEVENTY-FOUR PERCENT OF THE PARTICIPANTS EXCEEDED THE RECOMMENDED RANGE; COMPARED TO EIGHTY-ONE PERCENT IN 2018 AND SEVENTY-FIVE PERCENT IN 2017. UNFORTUNATELY, THIS IS CONSISTENT WITH THE NATIONAL TREND ALSO, WITH KENTUCKY AND SEVERAL OTHER STATES LEADING THE NATIONAL TREND. BODY MASS INDEX IS A MAJOR CONTRIBUTOR TO CVD RISK FACTORS, SOME TYPES OF CANCER AND DIABETES. THIS IS CONSISTENT WITH THE NATIONAL TREND AND WITH KENTUCKY BEING ONE OF THE LEAST HEALTHY STATES. EIGHTY PERCENT OF LIFESTYLE CHANGE IS IMPLEMENTATION OF THE CHANGE; TWENTY PERCENT IS THE KNOWLEDGE. BMI WAS ONE OF THE MODIFIABLE LIFESTYLE CHANGES IDENTIFIED AS A STRATEGY TO REDUCE CVD RISK AND CANCER RISK FROM THE 2017 CHNA STROKE SCREENING - THE AMERICAN STROKE ASSOCIATION STROKE RISK SCORECARD BECAME THE STANDARD TOOL FOR SCREENING FOR STROKE RISK WITHIN THE DEPARTMENT IN FISCAL YEAR 2012. STROKE RISK SCREENING WAS CONDUCTED AT 20 EVENTS IN FIVE COUNTIES INVOLVING 411 PARTICIPANTS WITH A 25% REFERRAL RATE; WHICH REFLECTS A 10% INCREASE OVER FY 2018 AND A 7% INCREASE OVER FY 2017. THIS IS ONE OF THREE SCREENING TESTS THAT RESULTED IN DIRECT REFERRAL AND TRANSPORT TO EMERGENCY CARE: THE OTHERS INCLUDE BLOOD PRESSURE IN THE STROKE RANGE, AND EXTREME ELEVATION OF LAB VALUES. THIS IS ONE OF THE STRATEGIES TO REDUCE CVD RISK OUTLINED IN THE IMPLEMENTATION PLAN FOR THE CHNA. COMMUNITY-BASED CLINICAL SERVICES - IMMUNIZATIONS ------------------------------------------------ FLU SHOTS - FLU SHOTS WERE ADMINISTERED AT 13 SITES COMPARED TO 19 SITES AND 20 EVENTS IN FY 2018, SEVENTEEN IN FY 2017 AND TEN IN FY 2016 IN MERCER, LINCOLN, BOYLE, GARRARD, AND WASHINGTON COUNTIES. IN FY 2019, 237 INDIVIDUALS RECEIVED THE INFLUENZA VACCINE COMPARED TO 531 INDIVIDUALS IN 2018 AND 554 INDIVIDUALS IN FY 2017 AGE 12 AND ABOVE. PRIMARY SITES WERE CHURCHES, DRUG REHABILITATION CENTERS/PROGRAMS, AND THE STOCKYARDS. COMMUNITY-BASED CLINICAL SERVICES-NONBILLED/REDUCED FEE CLINIC ------------------------------------------------------------------------ HOPE CLINIC & PHARMACY - HOPE CLINIC AND PHARMACY PROVIDED SERVICE TO 34 PATIENTS SEEN A TOTAL OF 77 TIMES. DUE TO A LACK OF A PROVIDER FROM MAY TO SEPTEMBER, CLINIC FIGURES WERE DOWN FROM THE 136 TOTAL VISITS IN FY 2017. TO QUALIFY FOR HOPE CLINIC & PHARMACY AN INDIVIDUAL MUST HAVE ONE OR MORE OF THE FOLLOWING DIAGNOSES: HYPERTENSION, DIABETES, OBESITY, HYPERLIPIDEMIA, HEART FAILURE, PNEUMONIA OR GASTRO ESOPHAGEAL REFLUX DISEASE, BE UNINSURED AND WITH A HOUSEHOLD INCOME BETWEEN 139% -300% OF THE FEDERAL POVERTY LEVEL. ALL STAFF MEMBERS ARE VOLUNTEERS EXCEPT THE PART-TIME LIP AND PART-TIME OFFICE MANAGER. THE CLINIC IS MANAGED BY A COMMUNITY ADVISORY BOARD WITH MEMBERS FROM THE BOYLE COUNTY HEALTH DEPARTMENT, DANVILLE PRESBYTERIAN CHURCH, EPHRAIM MCDOWELL HEALTH CARE FOUNDATION, EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER, HEART OF KENTUCKY UNITED WAY, AND THE SALVATION ARMY. THE CLINIC WAS STARTED DUE TO A COMMUNITY NEED BY A COLLABORATION OF THE KEY BOARD MEMBERS AND IS A DEPARTMENT OF EMRMC. THE AFFORDABLE CARE ACT HAS MADE POSSIBLE ACCESS TO EXPANDED MEDICAID IN KENTUCKY, RESULTING IN MANY FORMER HOPE CLIENTS HAVING INSURANCE AND ACCESS TO BOTH CHRONIC AND ACUTE CARE. BLOOD DRIVE - SEVENTY-EIGHT UNITS OF BLOOD WERE DONATED THROUGH BLOOD DRIVES IN THE HEALTH SYSTEM IN FY 2019 COMPARED TO 67 UNITS IN FY 2018. INDIVIDUALS THAT ARE ON DUTY ARE PAID DURING THE TIME THEY ARE INVOLVED IN THE DONATION PROCESS. HEALTH PROFESSIONS EDUCATION -------------------------- INTERNS, RESIDENTS, AND FELLOWS - IN FISCAL YEAR 2019 THERE WERE NEITHER INTERNS NOR FELLOWS AT EMRMC. THERE WERE TEN (10) EMERGENCY SERVICE RESIDENTS FROM UNIVERSITY OF KENTUCKY AND TWELVE (12) ORTHOPEDIC RESIDENTS FROM UNIVERSITY OF KENTUCKY. MEDICAL STUDENTS - TEN (10) MEDICAL STUDENTS ROTATED THROUGH EMERGENCY SERVICES AND FAMILY MEDICINE WITH EMRMC MEDICAL STAFF MENTORS. THIS REPRESENTS A SEVENTY-FIVE PERCENT DECREASE IN THE NUMBER OF MD STUDENTS. STUDENTS WERE FROM UNIVERSITY OF KENTUCKY, UNIVERSITY OF LOUISVILLE AND LINCOLN MEMORIAL UNIVERSITY. THIRTY-THREE (33) PHYSICIAN ASSISTANT (PA) STUDENTS ROTATED THROUGH EMERGENCY, SURGICAL, ORTHOPEDIC AND FAMILY MEDICINE SERVICES WITH A MENTOR. THIS REPRESENTS A SIXTY PERCENT INCREASE IN THE NUMBER OF PA STUDENTS. AFFILIATED PROGRAMS INCLUDED THE UNIVERSITY OF KENTUCKY, UNIVERSITY OF THE CUMBERLANDS AND MARIETTA COLLEGE. THIRTY-FIVE (35) NURSE PRACTITIONERS (NPS) OR ADVANCED PRACTICE NURSES (APRNS) ROTATED THROUGH EMERGENCY SERVICES OR PRIMARY CARE CLINICS IN FY 2019 WITH A LIP MENTOR. THIS REPRESENTS A SEVENTY PERCENT DECREASE IN THE NUMBER OF NP OR APRN STUDENTS. SCHOOLS INCLUDED: EASTERN KENTUCKY UNIVERSITY, CHAMBERLIN COLLEGE OF NURSING, VANDERBILT UNIVERSITY, INDIANA WESLEYAN UNIVERSITY, FRONTIER NURSING UNIVERSITY AND WALDEN UNIVERSITY. TWO (2) CERTIFIED REGISTERED NURSE ANESTHETISTS (CRNA) STUDENTS AND ONE (1) PAIN MANAGEMENT STUDENT ROTATED THROUGH EMRMC FROM UNIVERSITY OF KENTUCKY AND LINCOLN MEMORIAL UNIVERSITY. NURSING - FIVE HUNDRED AND TWO NURSING STUDENTS COMPLETED THEIR CLINICAL EXPERIENCE AND/OR PRACTICUM AT EMRMC IN FY 2018. EDUCATIONAL PARTNERS INCLUDED CAMPBELLSVILLE UNIVERSITY, EASTERN KENTUCKY UNIVERSITY, MIDWAY UNIVERSITY, BLUEGRASS COMMUNITY & TECHNICAL COLLEGE, BECKFIELD COLLEGE, KENTUCKY STATE UNIVERSITY, WESTERN KENTUCKY UNIVERSITY AND BEREA COLLEGE. THIS REPRESENTS A 9.5 PERCENT INCREASE IN NURSING STUDENTS, LPN, AD, AND BSN. OTHER ALLIED HEALTH PROFESSIONS - THE CERTIFIED NURSING ASSISTANT COURSE HAD 0 STUDENTS ENROLLED IN 2018 COMPARED TO 9 IN 2017. THIS IS DUE TO THE DECLINE IN ENROLLED STUDENTS AND THE ABILITY TO ACCOMMODATE A CLASS. EMRMC SERVED AS A CLINICAL SITE FOR STUDENTS FROM MULTIPLE DISCIPLINES FROM THE FOLLOWING INSTITUTIONS: BLUEGRASS COMMUNITY & TECHNICAL COLLEGE - LEXINGTON AND SOMERSET, BECKFIELD COLLEGE, BEREA COLLEGE, CAMPBELLSVILLE UNIVERSITY, EASTERN KENTUCKY UNIVERSITY, KENTUCKY STATE UNIVERSITY AND MIDWAY UNIVERSITY. THERE WAS A DECLINE IN THE NUMBER OF ALLIED HEALTH STUDENTS IN THE FOLLOWING AREAS: RADIOGRAPHY, SONOGRAPHY, DIETETIC, PHYSICAL THERAPY ASSISTANTS, AND HEALTH INFORMATION AND PHLEBOTOMY STUDENTS. THERE WAS A NINE PERCENT INCREASE IN THE NUMBER OF PHARMACY STUDENTS AND AN INCREASE IN THE NUMBER OF SPEECH THERAPY STUDENTS AND OCCUPATIONAL THERAPY STUDENTS. ONE HUNDRED NINETY-ONE AREA STUDENTS HAD A JOB SHADOWING EXPERIENCE IN 40 DIFFERENT AREAS OF EMRMC IN FY 2019. FINANCIAL DONATIONS FOR THE COMMUNITY - IN KIND ------------------------------------------------ PERSONNEL/ADMINISTRATIVE SUPPORT - AN ADVANCED PRACTICE NURSE SERVES ON THE MERCER COUNTY HEALTH DEPARTMENT BOARD. A STAFF MEMBER SERVES ON THE FOUNDATION FOR HEALTHY KENTUCKY BOARD AND SUBCOMMITTEES. THE REHABILITATION SERVICES DIRECTOR SERVES ON THE PHYSICAL THERAPY BOARD AND THE KENTUCKY HEALTH COLLABORATIVE. THE VICE PRESIDENT SERVED ON SENOR CITIZEN CENTER BOARD OF DIRECTORS AND THE SMOKING CESSATION COMMITTEE FOR KENTUCKY HEALTH COLLABORATIVE. THE EPHRAIM MCDOWELL HEALTH CARE FOUNDATION DONATED 10 ADDS, VALUED AT $15,000 TO THE DANVILLE POLICE DEPARTMENT. COMMUNITY BUILDING ACTIVITIES ---------------------------- COALITION BUILDING - HEROIN OVERDOSE AND DEATHS IN THE SERVICE AREA HAVE INCREASED AT AN ALARMING RATE. A MENTAL HEALTH PROFESSIONAL FROM CENTRE COLLEGE HAS PUT TOGETHER A BROAD COMMUNITY COALITION TO ADDRESS THE MANY FACETS OF THIS PUBLIC HEALTH ISSUE. THE EMERGENCY DEPARTMENT NURSING AND MEDICAL DIRECTORS HAVE WORKED WITH THIS GROUP. ASSOCIATES WORKED WITH THE ASAP COMMITTEE. COMMUNITY HEALTH IMPROVEMENT ADVOCACY - REHABILITATION SERVICES STAFF SERVED ON THE FEDERATION OF STATE PHYSICAL THERAPY BOARD. WORKFORCE DEVELOPMENT - THE SOUTHERN AREA HEALTH EDUCATION COUNCIL IS INVOLVED IN THE EDUCATION OF HEALTHCARE PROFESSIONALS IN RURAL SOUTH-CENTRAL KENTUCKY AND HEALTH POLICY. FORM 990, PART III, LINE 4A (CONT) COMMUNITY BENEFIT OPERATIONS ------------------------- COMMUNITY HEALTH NEEDS ASSESSMENT - PROFESSIONAL RESEARCH CONSULTANTS OF OMAHA, NEBRASKA WERE ENGAGED TO CONDUCT A SCIENTIFICALLY VALID SIX COUNTY CHNA FOR THE SYSTEM, INCLUDING EMRMC, AT A COST OF $83,000. THE CONFIDENCE LEVEL IS 95 PERCENT FROM A SAMPLE OF 900 AREA RESIDENTS. A COMMUNITY FOCUS GROUP WAS CONVENED FOR INPUT FROM KEY INFORMANTS FROM THE SIX COUNTIES, WITH FINDINGS INCLUDED IN THE REPORT. THE RESULTS WERE MADE AVAILABLE TO THE GOVERNING BOARD IN HARD COPY ALONG WITH A SUMMARY PRESENTATION AND IMPLEMENTATION PLAN FOR 2018-2021. ONCE REVIEWED BY THE BOARD, THE REPORT AND IMPLEMENTATION PLAN WERE POSTED ON THE WEBSITE FOR PUBLIC ACCESS. SELECT SHARING WAS DONE UPON REQUEST BY COMMUNITY ORGANIZATIONS AND CENTRE COLLEGE STUDENTS. DEDICATED STAFF - THERE IS ONE STAFF MEMBER WHO WORKS PART TIME FOR COMMUNITY SERVICE AND SEVERAL FLEX RNS AND TECHNICIANS THAT WORK AS NEEDED WITHIN THE COMMUNITY SERVICE DEPARTMENT AND ARE FUNDED BY THE HEALTH SYSTEM. THE STAFF WAS COMPRISED OF A FAITH COMMUNITY NURSING COORDINATOR WHO WORKS OUT OF ANOTHER DEPARTMENT, AND A PART TIME PROJECT COORDINATOR, ALL REPORTING TO THE SYSTEM DIRECTOR, NURSING ADMINISTRATION, REGULATORY COMPLIANCE, ASSOCIATE EDUCATION, AND COMMUNITY SERVICES. TOTAL SALARY EXPENSES FOR DEDICATED COMMUNITY BENEFIT STAFF WERE $178,700 FOR FY 2019; WITH THE DECREASE REFLECTING THE REDUCTION IN HOURS WITHIN THE DEPARTMENT. COMMUNITY SERVICES TOTAL EXPENSES WERE $230,3043. THERE WAS A PART TIME NURSE PRACTITIONER AND OFFICE MANAGER FOR THE HOPE CLINIC. SALARY EXPENSES WERE $4,794.09 FOR FY 2019. THE REPORTING STRUCTURE IS THAT ALL DEPARTMENT FUNCTIONS REPORT TO THE SYSTEM DIRECTOR. THE SYSTEM DIRECTOR THEN REPORTS TO THE EPHRAIM MCDOWELL HEALTH SYSTEM VICE PRESIDENT OF COMMUNITY ENGAGEMENT AND POPULATION HEALTH WHO REPORTS TO THE GOVERNING BOARD WITH THE ANNUAL WORK PLAN AND BUDGET APPROVED BY THE GOVERNING BOARD. IN THE SPRING OF 2017, THE NEW COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN WERE PRESENTED TO THE GOVERNING BOARD FOR APPROVAL. UNASSIGNED SECTION ------------------ UNASSIGNED PROGRAM - EMRMC STAFF VOLUNTEERED IN AREA CHURCHES AND CHILDREN'S MINISTRY PROGRAMS WITHIN THE SERVICE AREA THAT FOCUSED ON SPIRITUAL DEVELOPMENT AND WELL-BEING, APPROXIMATELY 800 CHILDREN WERE SERVED. OTHER SERVICES INCLUDE VOLUNTEER FAITH COMMUNITY NURSES SERVING WITHIN MANY OF THE LOCAL CONGREGATIONS. THE RESULT BEING BLOOD PRESSURE SCREENING, COORDINATION OF CARE, REFERRALS, AND EDUCATION RELATED TO HEALTH RISK, MEDICATIONS, MENTAL HEALTH, STROKE RISK EDUCATION, AND OTHER ISSUES. OTHERS SERVED IN MUSIC MINISTRY, VISITATION, OR CHURCH BASED COMMITTEES. MANY SERVED IN YOUTH SPORT LEAGUES AS VOLUNTEERS, EITHER COACHING OR RAISING FUNDS. OTHERS VOLUNTEERED WITH THE SCHOOL SYSTEM SERVING AS ROOM SPONSORS, BOOSTERS, PTA OFFICERS, MENTORING STUDENTS, OR OTHER NEEDED FUNCTIONS. EMRMC ASSOCIATES VOLUNTEERED AT THE LOCAL FESTIVALS INCLUDING, BUT NOT LIMITED TO: HARVEST FEST ON MAIN, KENTUCKY STATE BBQ FESTIVAL, GREAT AMERICAN BRASS BAND FESTIVAL, SOUL ON SECOND STREET, DANVILLE'S LAWN CHAIR THEATRE, APPLE FESTIVAL IN CASEY COUNTY, BEEF FESTIVAL IN MERCER COUNTY, PARTY ON THE SQUARE IN GARRARD COUNTY, FORKLAND HERITAGE FESTIVAL AND REVUE, BATTLE OF PERRYVILLE COMMEMORATION, CRUISE, BLUES & BAR-B-QUE, AND RAILROAD DAYS. THESE HOURS WERE NOT PAID HOURS, THEREFORE NOT INCLUDED IN THE COMMUNITY BENEFIT CALCULATIONS. NEVERTHELESS, THIS INVESTMENT OF TIME AND LABOR CONTRIBUTED SIGNIFICANTLY TO THE QUALITY OF LIFE IN THE REGION - IMPACTING PHYSICAL, MENTAL, AND ECONOMIC WELL-BEING OF THE POPULACE OF THE SIX COUNTY SERVICE AREAS. DEFERRED NEEDS FROM THE CHNA OF BOYLE AND THE SURROUNDING COUNTIES BASED UPON RESOURCES AND/OR EXPERTISE INCLUDED THE FOLLOWING: SUBSTANCE ABUSE IS AN ISSUE IN THE STATE AND REGION. ADDICTION SERVICES ARE OFFERED BY PRIVATE PROVIDERS, COMPREHENSIVE CARE, AND SELF-REFINED IN THE REGION. EMRMC BEHAVIORAL MEDICINE UNIT DOES TREAT DUAL DIAGNOSIS PATIENTS AND THE PSYCHIATRISTS AND COUNSELORS TREAT OUT PATIENTS. THERE IS AN ACTIVE ALCOHOLICS ANONYMOUS CHAPTER. CELEBRATE RECOVERY IS OFFERED AT VARIOUS SITES IN THE SERVICE AREA. SUBSTANCE ABUSE TASK FORCE RESOURCES AND COMMITTEES ARE IN THE SURROUNDING SERVICE AREA, AND COLLABORATION OCCURS AS NEEDED. DUE TO LACK OF EXPERTISE AND RESOURCES, ADDICTION WILL BE DEFERRED AS PART OF THE WORK PLAN BY EMRMC. CHRONIC KIDNEY DISEASE AND END STAGE RENAL FAILURE LINKS TO DIABETES. MODERATE EXERCISE, A HEALTHIER DIET, AND WEIGHT REDUCTION CAN PREVENT THE DEVELOPMENT OF TYPE 2 DIABETES IN PERSONS AT RISK (DIABETES PREVENTION PROGRAM FUNDED BY NIH). THE FREE SCREENINGS WILL PROVIDE EARLY DETECTION AND POSSIBLY PREVENTION WHEN ADDRESSING NUTRITION, BODY MASS INDEX AND EXERCISE. SOME FAITH COMMUNITY NURSES IN CONGREGATIONS ASSESS BLOOD PRESSURES AND MEDICATION ADHERENCE AS WELL AS PROVIDE EDUCATION. RENAL SPECIALISTS AND DIALYSIS CENTERS SERVE THIS POPULATION AS WELL. DEMENTIA LINKS TO CV HEALTH AND STROKE INCIDENCE AND VASCULAR ISSUES. IT ALSO LINKS TO THE AGING OF THE POPULATION IN THE REGION. THERE IS AN ALZHEIMER'S SUPPORT GROUP IN BOYLE AND MERCER COUNTIES. ALSO, MENTAL EVALUATION AND MEDICATION MANAGEMENT IS AVAILABLE BY A PSYCHIATRIST AT THE MEDICAL CENTER. DANVILLE HEALTH & REHABILITATION CENTER AS WELL AS MORNING POINT HAS AN ALZHEIMER'S LONG-TERM CARE UNIT. THE SANDERS BROWN CENTER AT THE UNIVERSITY OF KENTUCKY HAS ON-GOING ALZHEIMER'S RELATED RESEARCH AND SERVES AS A REFERRAL CENTER FOR THE REGION. BIRTHS TO TEENAGERS AND UNWED MOTHERS, AND LOW BIRTH-WEIGHT BIRTHS ARE BEING ADDRESSED BY THE HEALTH DEPARTMENTS AND THE SCHOOL HEALTH COLLATIONS. THE LINCOLN COUNTY HEALTH DEPARTMENT HAS A 5-YEAR GRANT TO ADDRESS SELF-ESTEEM AND CHARACTER BUILDING IN 6TH GRADE THROUGH MIDDLE SCHOOL. THE LINCOLN AND BOYLE COUNTY SCHOOL NURSES CONDUCT THE PERKINS ASSESSMENT IN MIDDLE SCHOOL THROUGH HIGH SCHOOL AS PART OF THE EFFORT TO HELP YOUTH MAKE FEWER HIGH-RISK BEHAVIOR CHOICES. BOTH SCHOOL SYSTEMS HAVE CONTRACTS WITH THE UNIVERSITY OF KENTUCKY FOR THE SERVICES OF AN ADOLESCENT MEDICINE SPECIALIST FOR ON-SITE SERVICES. THE HAVEN CARE CENTER PROVIDES PREGNANCY RESOURCES AND SUPPORTS ALL SIX COUNTIES. CHRONIC LUNG/RESPIRATORY DISEASE IS BEING ADDRESSED WITH TOBACCO EDUCATION, STOP SMOKING CLASSES AT THE HEALTH DEPARTMENTS, PULMONARY REHAB AT EPHRAIM MCDOWELL SPECIALTY CENTER AND THROUGH PUBLIC POLICY. THE COMMUNITY SERVICE DEPARTMENT SCREENS FOR TOBACCO USE AT ALL VENUES AND REFERS CLIENTS TO THE HEALTH DEPARTMENTS. THE HEALTH DEPARTMENT OFFERS FREEDOM FROM SMOKING CLASSES TO HELP RESIDENTS STOP SMOKING. THE HEALTH DEPARTMENTS ALSO CONDUCT TOBACCO EDUCATION IN THE SCHOOL SYSTEMS. IN THE AREAS OF INFECTIOUS DISEASE, THE COUNTY HEALTH DEPARTMENTS WILL CONTINUE TO ADDRESS HIV EDUCATION AND TESTING. HEPATITIS C VACCINE IS AVAILABLE AT THE HEALTH DEPARTMENTS. EMRMC WILL DEFER DUE TO RESOURCE ALLOCATION - BOTH PERSONNEL AND TIME. INJURY AND VIOLENCE EDUCATION IS IN THE HEALTH DEPARTMENTS, COUNTY EXTENSION OFFICES, SCHOOL RESOURCE CENTERS, FAMILY COURT, AND LAW ENFORCEMENT IN ALL COUNTIES. EMRMC AND EMFLH OFFER THE SERVICES OF A SANE NURSE FOR RAPE VICTIMS. THE RAPE CRISIS CENTER SERVES THE REGION. EMRMC WILL DEFER FOCUS ON INJURY AND VIOLENCE AT THIS TIME DUE TO OTHER AGENCIES COVERING ALL ASPECTS, HAVING GREATER EXPERTISE AND DEPARTMENTAL RESOURCE LIMITATIONS. COLLABORATION WITH LOCAL ORGANIZATIONS WORKING ON SAFE COMMUNITIES WAS DISCUSSED AT THE PRIORITIZATION MEETING. ORAL HEALTH INCLUDING REGULAR DENTAL CARE AND DENTAL INSURANCE IS A REGIONAL ISSUE. EPHRAIM MCDOWELL HEALTH BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. WORK PLAN INITIATIVES IN FY 2019 BASED UPON THE 2018 CHNA BY PROFESSIONAL RESEARCH CONSULTANTS INCLUDED: - TO SCREEN FOR MODIFIABLE LIFESTYLE FACTORS RELATED TO DIABETES AND EDUCATE REGARDING RISK REDUCTION STRATEGIES AND REFER FOR FURTHER EVALUATION AS NEEDED. - TO IMPROVE BARRIERS TO ACCESS PRESCRIPTION MEDICATION REGIMEN, SUCH AS COST AND COMPLIANCE, BY COMMUNITY MEMBERS. - TO SCREEN FOR COLORECTAL AND SKIN CANCER AND TO PROVIDE EDUCATION REGARDING LIFESTYLE CHANGES RELATED TO RISK FACTOR REDUCTION; REFER FOR FURTHER EVALUATION AS NEEDED. - TO SCREEN FOR MODIFIABLE LIFESTYLE FACTORS RELATED TO CARDIOVASCULAR RISK AND PROVIDE EDUCATION REGARDING REDUCTION STRATEGIES; REFER FOR FURTHER EVALUATION AS NEEDED. FORM 990, PART III, LINE 4A (CONT) CONCLUSION: ALL COMPONENTS OF THE WORK PLAN APPROVED BY THE GOVERNING BOARD WERE IMPLEMENTED AND THERE IS SOME HEALTH RISK IMPROVEMENTS NOTED: CHANGES IN TREND LINES SINCE 2016 OBSERVED IN 2019 INCLUDE THE FOLLOWING: ABNORMAL TOTAL CHOLESTEROL VALUES ARE BASICALLY UNCHANGED FROM 2017 BUT INCREASING FROM 2015. THERE WAS A SIGNIFICANT DECREASE IN BLOOD GLUCOSE VALUES ABOVE OF RECOMMENDED RANGE. UNCONTROLLED BLOOD PRESSURE (HYPERTENSION) VALUES REMAINED RELATIVELY UNCHANGED FROM FY 2017 BUT HAVE DECREASED FROM 2016. THE REFERRAL RATE TO PCP HAS DECREASED. THIS MAY REFLECT VALUES NOT BEING AS HIGH AS PREVIOUS YEARS. THERE IS AN INCREASED TREND IN MORE INDIVIDUALS WITH A PRIMARY CARE PROVIDER. MORE INDIVIDUALS WERE UNEMPLOYED AND RETIRED. INCOME REMAINS CONSISTENT WITH FY 2017 BUT THERE IS AN INCREASE IN LOWER INCOME LEVELS FROM FY 2015. THERE IS A CONTINUED TREND OF SEEING FEWER MALE SEEKING SCREENING AND AN INCREASE IN FEMALE SEEKING SCREENING. THERE IS A DECREASING TREND IN TOBACCO USE. IN FY 2019, EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER INVESTED $7,452,218 IN COMMUNITY BENEFIT INCLUDING FINANCIAL ASSISTANCE AND MEANS-TESTED PROGRAMS. THE FINANCIAL INVESTMENT WAS ABOVE AND BEYOND THE HOURS OF VOLUNTEER TIME IN LEADERSHIP ROLES BY EMRMC STAFF TO IMPROVE HEALTH, EDUCATION, ENVIRONMENT, ECONOMIC DEVELOPMENT AND LEGISLATIVE ENDEAVORS WITHIN THE COMMUNITY, STATE AND AT THE NATIONAL LEVEL. FORM 990, PART V, LINE 2A COMMON PAYMASTER ------------------- EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER IS THE COMMON PAYMASTER FOR THE FOLLOWING RELATED ORGANIZATIONS: EPHRAIM MCDOWELL HEALTH, INC., EPHRAIM MCDOWELL HEALTH RESOURCES, INC., EPHRAIM MCDOWELL HEALTH CARE FOUNDATION, INC., JOHN HILL BAILEY CHILDREN'S LEARNING CENTER, INC., EMHFL, INC., COOPERATIVECARE, INC., AND JAMES B. HAGGIN MEMORIAL HOSPITAL, INC. ALL SALARIES AND PAYROLL TAXES ARE REPORTED ON A CONSOLIDATED FORM 941. THE EIN ON THE FORM 941 IS 61-0492356. FORM 990, PART VI, SECTION B, LINE 6, 7A, & 7B MEMBERS OF THE ORGANIZATION ----------------------- EPHRAIM MCDOWELL HEALTH, INC. IS THE SOLE CORPORATE MEMBER OF EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER. EPHRAIM MCDOWELL HEALTH, INC., A RELATED 501(C)(3) ENTITY, IS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. EPHRAIM MCDOWELL HEALTH, INC. ELECTS BOARD MEMBERS OF EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER ON AN ANNUAL BASIS. THE BYLAWS OF EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER REQUIRE APPROVAL OF CERTAIN TRANSACTIONS BY EPHRAIM MCDOWELL HEALTH, INC. FORM 990, PART VI, SECTION B, LINE 11 PROCESS TO REVIEW FORM 990 ------------------------------- COPIES OF THE FORM 990 ARE SUBMITTED TO THE FULL BOARD VIA EMAIL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12B & 12C MONITORING THE CONFLICT OF INTEREST POLICY ------------------------------------- ANNUALLY, BOARD OF DIRECTORS, SENIOR LEADERSHIP AND MEDICAL STAFF LEADERS COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. COMPLETION OF THE ANNUAL QUESTIONNAIRE IS COORDINATED BY GENERAL COUNSEL AND EPHRAIM MCDOWELL'S CORPORATE COMPLIANCE OFFICER. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE SENIOR LEADERSHIP AND THE CORPORATE COMPLIANCE OFFICER. THE CHAIRMAN OF THE BOARD OF DIRECTORS IS MADE AWARE OF CONFLICTS WHICH HAVE BEEN DISCLOSED ON ANNUAL STATEMENTS. IF CONFLICTS EXISTS, THE CONFLICT IS DISCLOSED AND THE INDIVIDUAL WITH THE CONFLICT DOES NOT PARTICIPATE OR VOTE ON ACTIVITIES WHERE A CONFLICT OF INTEREST IS PRESENT. FORM 990, PART VI, SECTION B, LINE 15A & 15B PROCESS FOR DETERMINING COMPENSATION ----------------------------------------- EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER IS PART OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM WHOSE PARENT IS EPHRAIM MCDOWELL HEALTH, INC. COMPENSATION FOR ALL AFFILIATES IS OVERSEEN AND COORDINATED THROUGH EPHRAIM MCDOWELL HEALTH, INC. THE MERCER GROUP, INDEPENDENT CONSULTANTS, CONDUCTED A REVIEW AND PROVIDED MARKET DATA IN 2018 FOR ESTABLISHING REASONABLE COMPENSATION OF THE CEO. FOR OTHER OFFICERS AND KEY EMPLOYEES FOR THE SYSTEM, THE ORGANIZATION ALSO UTILIZED COMPENSATION STUDIES. THE COMPENSATION IS APPROVED BY THE COMPENSATION COMMITTEE OF THE EPHRAIM MCDOWELL HEALTH, INC. BOARD OF DIRECTORS. THE DECISION AND PROCESS IS DOCUMENTED BY THE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 MAKING FORMS AVAILABLE TO THE PUBLIC ------------------------------------- THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED MEDICAL SERVICES TOTAL FEES:15586169 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:7856567 JOHN HILL BAILEY CHILDREN'S LEARNING CTR 217 SOUTH THIRD STREET DANVILLE KY 40422 611186005 DAYCARE CTR KY 501(C)(3) 2 EM HEALTH false EMHFL INC 217 SOUTH THIRD STREET DANVILLE KY 40422 611388556 CRITICAL HOSP KY 501(C)(3) 3 EM HEALTH false EPHRAIM MCDOWELL HEALTH RESOURCE INC 217 SOUTH THIRD STREET DANVILLE KY 40422 311545520 HEALTHCARE KY 501(C)(3) 3 EM HEALTH false EPHRAIM MCDOWELL HEALTH CARE FOUNDATION 217 SOUTH THIRD STREET DANVILLE KY 40422 611229333 FUNDRAISING KY 501(C)(3) 12B-II EM HEALTH false EPHRAIM MCDOWELL HEALTH INC 217 SOUTH THIRD STREET DANVILLE KY 40422 611324736 MGT SERVICES KY 501(C)(3) 12B-II NA false MCDOWELL HOME HEALTH AGENCY INC 217 SOUTH THIRD STREET DANVILLE KY 40422 610715227 HOME HEALTH KY 501(c)(3) 3 EM HEALTH false JAMES B HAGGIN MEMORIAL HOSPITAL 464 LINDEN AVENUE HARRODSBURG KY 40330 610510934 CRITICAL HOSP KY 501(C)(3) 3 EM HEALTH false CKSC 217 S 3RD DANVILLE KY 40422 371509373 MEDICAL SERVICES KY EMRMC RELATED 1781384 2555221 false 0 false 0.60000 COOPERATIVECARE INC 217 SOUTH THIRD STREET DANVILLE KY 40422 611265715 CONTRACTING SVCS KY NA C 0 0 0.00000 false false false true false false false false false false false false false false false false true true false true CENTRAL KENTUCKY SURGERY CENTER LLC P 10661127 FMV